Giraud N, Popinat G, Regaieg H, Tonnelet D, Vera P
Radiation Oncology Department, hôpital Haut-Lévêque, CHU de Bordeaux, avenue Magellan, 33600 Pessac, France.
Nuclear Medicine Department, centre Henri-Becquerel, 1, rue d'Amiens, 76038 Rouen, France.
Cancer Radiother. 2020 Aug;24(5):437-443. doi: 10.1016/j.canrad.2020.02.009. Epub 2020 Apr 1.
Radiation therapy has undergone significant advances these last decades, particularly thanks to technical improvements, computer science and a better ability to define the target volumes via morphological and functional imaging breakthroughs. Imaging contributes to all three stages of patient care in radiation oncology: before, during and after treatment. Before the treatment, the choice of optimal imaging type and, if necessary, the adequate functional tracer will allow a better definition of the volume target. During radiation therapy, image-guidance aims at locating the tumour target and tailoring the volume target to anatomical and tumoral variations. Imaging systems are now integrated with conventional accelerators, and newer accelerators have techniques allowing tumour tracking during the irradiation. More recently, MRI-guided systems have been developed, and are already active in a few French centres. Finally, after radiotherapy, imaging plays a major role in most patients' monitoring, and must take into account post-radiation tissue modification specificities. In this review, we will focus on the ongoing projects of nuclear imaging in oncology, and how they can help the radiation oncologist to better treat patients. To this end, a literature review including the terms "Radiotherapy", "Radiation Oncology" and "PET-CT" was performed in August 2019 on Medline and ClinicalTrials.gov. We chose to review successively these novelties organ-by-organ, focusing on the most promising advances. As a conclusion, the help of modern functional imaging thanks to a better definition and new specific radiopharmaceuticals tracers could allow even more precise treatments and enhanced surveillance. Finally, it could provide determinant information to artificial intelligence algorithms in "-omics" models.
在过去几十年中，放射治疗取得了显著进展，这尤其得益于技术改进、计算机科学以及通过形态学和功能成像突破来更好地定义靶区的能力。成像在放射肿瘤学患者护理的三个阶段都发挥着作用：治疗前、治疗期间和治疗后。治疗前，选择最佳成像类型以及必要时选择合适的功能示踪剂，将有助于更好地定义靶区体积。在放射治疗期间，图像引导旨在定位肿瘤靶区，并根据解剖和肿瘤变化调整靶区体积。成像系统现在已与传统加速器集成，新型加速器具备在照射过程中进行肿瘤追踪的技术。最近，磁共振成像引导系统已得到开发，并且已在法国的一些中心投入使用。最后，在放射治疗后，成像在大多数患者的监测中起着重要作用，并且必须考虑到放射后组织改变的特殊性。在本综述中，我们将重点关注肿瘤学中正在进行的核成像项目，以及它们如何帮助放射肿瘤学家更好地治疗患者。为此，2019年8月在Medline和ClinicalTrials.gov上进行了一项文献综述，搜索词包括“放射治疗”“放射肿瘤学”和“PET-CT”。我们选择逐个器官地依次回顾这些新进展，重点关注最有前景的进展。总之，借助现代功能成像技术，通过更好地定义和使用新的特异性放射性药物示踪剂，可以实现更精确的治疗和加强监测。最后，它可以为“组学”模型中的人工智能算法提供决定性信息。
